门诊处方规范性和合理性点评

Evaluation of standard and rationality of prescriptions in outpatient department

目的提高处方质量，减少不合理处方，促进合理用药。方法以《处方管理办法》及《医院处方点评管理规范（试行）》为依据，对我院2008-2010年门诊处方进行分类分析，并根据卫生部制定的处方评价表，计算我院门诊处方用药指标。结果2008年调查处方22395张，不合格处方923张，不合格率4．12％；2009年调查处方20723张，不合格处方1025张，不合格率4．95％；2010年调查处方59462张，不合格2853张，不合格率4．80％。处方不合格率均在卫生部要求的5％以下。2008-2010年的用药指标均在WHO制定的发展中国家医疗机构门诊药品合理用药利用标准范围内。影响处方合格率的4种主要类型为诊断不规范、诊断书写不全；处方选择不正确；药品剂量、数量、单位书写错误；用法用量不适宜。结论我院门诊处方用药基本合理，处方不合格率大部分源于处方规范性方面问题。

Objective To improve the quality of prescription, to reduce the irrational prescription and promote rational drug use. Methods The irrational prescription for outpatients from 2008 to 2010 was studied based on the Law of Prescription Management and Hospital Management Practices about Prescription Comments （ Trial version）. The medication index was calculated according to the prescription evaluation form designed by ministry of health. Results The analysis showed that there were 16 types of irrational prescriptions in our hospital. Qualified rate of 2008, 2009 and 2010 were 95.88%, 95.05% and 95.2% respectively and irrational rates were 4.12%, 4.95% and 4.80% respectively. Therefore, all data was below 5% and met the requirements of the ministry of health. All medication indexes were within the range of rational drug use standard of Medical Institutions in Developing Countries. This standard was enacted by world health organization （WHO）. Conclusions The drug use and outpatient prescription are relatively reasonable in our hospital. The irrational prescription mainly is from nonstandard prescriptions.